Michelina Lillian Timenovich, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

14961 Issued in CA

Practice address

180 Niblick Rd
Paso Robles, CA 93446-4842

Phone

(805) 238-2540

Fax

(805) 430-3670

NPI assigned

Jun 11, 2014

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Michelina Timenovich Clark Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michelle Timenovich O.D., a Professional Optometry Corp.

  dba Wine Country Eyecare

  • Optometrist
  • Paso Robles, CA
  • NPI 1932612702
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1902210586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9367 RIBERENA CIR",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934226252",
            "telephone_number": "818-430-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NIBLICK RD",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934464842",
            "telephone_number": "805-238-2540",
            "fax_number": "805-430-3670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Plaza Dr Ste 304",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934546955",
            "country_code": "US",
            "telephone_number": "805-987-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 Gateway Center Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Paso Robles",
            "state": "CA",
            "postal_code": "934463753",
            "country_code": "US",
            "telephone_number": "805-987-5300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "835 Aerovista Pl Ste 110",
            "address_purpose": "LOCATION",
            "city": "San Luis Obispo",
            "state": "CA",
            "postal_code": "934018741",
            "country_code": "US",
            "telephone_number": "805-987-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIMENOVICH",
        "first_name": "MICHELINA",
        "middle_name": "LILLIAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-11",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELINA",
            "last_name": "CLARK",
            "middle_name": "TIMENOVICH",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Optometrist in Paso Robles, CA
• Providers in Paso Robles, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.